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Case histories: Recounting some terrible Alaska bear attacks

Any time someone is mauled by a bear there are two completely different points of view -- the victim's and the bear's. At least part of the victim's story can be told by their attending physician, and a bear's behavior may be explained by a wildlife biologist. Those two perspectives were juxtaposed at a recent meeting of the Anchorage Medical Society.

Although both specialize in a biological science, physicians and wildlife biologists inhabit worlds nearly as far apart as people and bears. When you take a class in biology in high school, you are introduced to the discipline's spectrum -- from molecular and cell biology to ecology, the study of natural communities. In college your biological interests and aptitude lead to specialization. You lean toward cells or organs, individuals or populations. Physicians familiarize themselves with cells and organs. Wildlife biologists are typically most interested in populations. I'm oversimplifying, but a doctor's diagnosis is more likely to depend on a microscope or blood test than a pair of binoculars.

The Anchorage Medical Society meets at a restaurant several times a year. The meetings have themes, and doctors present case histories. The theme for March: bear maulings. Four local physicians presented case histories of people mauled in Alaska in the past decade. For the bear's point of view, they invited Department of Fish and Game wildlife biologist Jessy Coltrane, who has investigated several maulings in the Anchorage area. I tagged along for the rare opportunity to experience bear maulings from the other side -- without getting mauled myself.

In this corner, the bears

Of course, a figurative mauling was possible. Both Coltrane and I have been in meetings where we've been bluff-charged by participants. In the small talk before the meeting, I got the impression that a few physicians might think eliminating bears in Anchorage was a good idea. To a wildlife biologist, an individual animal is expendable. Our "patients" are wildlife populations and species.

First up, Coltrane outlined some basic facts about local bear populations. Anchorage is surrounded by bears. Some 250-350 black bears and at least 65 brown bears are found between the Knik and Portage rivers. Some bears come into the city and outlying communities. Anchorage is well stocked with natural bear foods like berries, salmon, and moose calves. Many brown bears use Far North Bicentennial Park in summer and fall because salmon spawning in the park waterways provide a critical, but limited food source. Fish and Game biologist Sean Farley has figured out the local brown bear diet by analyzing hairs taken from 12 collared bears. Salmon constituted 37 percent -- pretty amazing considering the few salmon streams in the Anchorage area and the relatively brief period when spawning salmon are available.

Black bears speak highly of our garbage.

Anchorage's large human population and a healthy number of bears ensures plenty of bear-human interactions. Anchorage residents and visitors have been attacked in Chugach State Park and on edge of the city. Not all maulings result in serious injuries; mauling only means the bear drew blood. Coltrane enumerated all known maulings in the Anchorage area since 1908:

Five black bear maulings, all single bites or swats;

Sixteen brown bear maulings. Two brown bear maulings were fatal. About a third of the remaining maulings were relatively minor – a bite or scratches. Another third were serious, and the final third was something in between. Most have occurred in the past two decades.

Coltrane explained how Fish and Game works with the Municipality of Anchorage and other agencies to minimize bear-human conflicts, especially maulings.

First, it's only common sense to stop baiting bears into the city with unsecured garbage. Coltrane also advises agencies to close trails when bear hazards are elevated, particularly when brown bears are fishing for salmon. And some trails shouldn’t be built or improved, especially if the immediate area is known to support a seasonal concentration of brown bears.

Like everything else at Fish and Game, bear safety has become politicized in recent years. The former director of the Alaska Division of Wildlife Conservation, Corey Rossi, forbade biologists from telling the public that some Anchorage neighborhoods attract more bears than others. That contradicted nearly 40 years of good advice to the contrary. Anchorage Mayor Dan Sullivan has refused to temporarily close a recreational trail after a bear mauling or when informed that brown bears are concentrated near the trail. No other public official in Alaska subscribes to that policy as far as I know. One trail in Anchorage, Rover's Run in Far North Bicentennial Park, had three maulings in three years, but Sullivan still sat on his hands.

Some Anchorage residents, including the mayor, believe Fish and Game is coddling the bears. But Coltrane is not just offering information and advice. She (and I before her) have increased bear hunting opportunities near Anchorage.

In recent years, 75-100 black bears have been shot in Anchorage and Chugach State Park annually. In 2008, an estimated one-third of the local black bear population was shot, mostly in Chugach State Park. That was not a sustainable rate of mortality. Last year, a record seven brown bears were shot in the Anchorage area. Fish and Game still opposes bear hunts in neighborhoods or city parks because no one wants a wounded bear in their yard. However, biologists shoot bears that pose a serious threat.

'God help me'

After Coltrane's brief presentation, the four physicians launched into their case histories. Each doctor shared photos taken before and after surgery. To protect their privacy, I won't use the patients' names. Only one of the case histories described a mauling from the Anchorage area.

Dr. Sarah Troxel insisted her operation was the easiest of the four. In an unexpected twist, the bear assisted the surgery. Troxel's patient had multiple scalp lacerations. She compared the lacerations to "face-lift incisions" because they were such clean cuts, not the ragged tears she anticipated. However, there were so many deep cuts that she opted to not shave her patient's head. Each time she thought she'd finished stitching the final wound -- time to bring the patient out of anesthesia -- she'd find another massive laceration. All told, her patient had "hundreds and hundreds of centimeters of lacerations on his scalp." He also had deep lacerations on flank and thigh, two broken ribs, hand lacerations, and both ears were nearly torn off. He lost a lot of blood before he arrived at the hospital.

In a photo taken in the field shortly after the attack the victim's head and shirt were soaked in blood and he had the 1,000-yard stare of a combat veteran. The rim of one ear dangled. He told Troxel that the bear had knocked him down, grabbed the back of his head in its jaws and lifted him off the ground. This triggered an out-of-body experience, a sense of looking down on himself and the bear. He struggled. The bear's jaws lost their grip, then regained it. He told Troxel he screamed out loud, "God help me." The bear dropped him, turned and left.

Most bear mauling victims have both physical and psychological scars. In his "after" photo, there is no obvious evidence of the attack. All of the scars appeared to be covered with hair. But Troxel said her patient isn't the same man as before the attack. He's been diagnosed with post-traumatic stress disorder. He's more emotional, more spiritual. He stops by her office often "just to say hi." She called him a "lovely man."

Condolences from space

Brown bears often attempt to grip a victim's skull with their canines. This is one way bears fight one another, and scientists like Dr. Stephen Herrero, who have investigated a great many bear maulings, have found scalp lacerations are common in human victims. In most cases the bear's jaws cannot open wide enough to compress or puncture an adult's skull. Their canines slide off the smooth bone, tearing the scalp. Some victims remember the sound of teeth scraping on bone as one of the most chilling aspects of the attack.

The second case history was presented by Dr. Creed Mamikunian. In this instance, the bear had gripped the patient's head so violently that its canines slightly penetrated his skull at both temples. Fortunately, like the first case, the bites were predominantly to the rear, and the brain itself was not injured. "It could have been a whole lot worse," Mamikunian said. Walking into the operating room, Mamikunian found the patient with a big bandage around his head, but he was totally alert and appeared to be unfazed by his wounds. Mamikunian and a partner removed the skull fragments and treated the scalp lacerations: four hours of sewing an estimated 300-400 sutures and staples. The "after" photo of the top of the patient's shaved head showed multiple curved lacerations stitched like the seams of a baseball. A year later, Mamikunian reported, the patient "looked good." And in what may be a first in the annals of bear maulings, the patient received an email conveying best wishes from the astronauts aboard the International Space Station on the second or third day of recovery.

A sucking neck wound

In arranging the meeting's agenda, Dr. Mamikunian had scheduled the presentations in order of severity, from least to worst.

Dr. Dwight Ellerbe treated the third patient. The patient's injuries were severe: multiple, deep, curved lacerations across the thigh, a collapsed lung, two fractured ribs, lacerations and punctures in neck and shoulder, a punctured trachea, and a longitudinal rip in the carotid artery. Ellerbe likened the neck wounds to the infamous sucking chest wound many of us learned about in first-aid class.

Another life-threatening injury was the torn carotid artery. There were no carotid stents of the correct size in Anchorage. A member of the medical team flew to Seattle, picked up the stent and brought it back for the operation. Another concern was loss of fluid. The patient absorbed 15 liters of fluid during the initial operation.

Seriousness of the injuries can be expressed in other numbers: eight hours in the operating room, more than 15 physicians, 15 days in intensive care, nine surgeries, nine units of blood. But these figures don't account for physical pain and mental anguish.

Most bear-mauling victims exhibit a strong will to survive. By all accounts, this patient has the will to excel.

A roadmap of sutures

Finally, it was time for the most serious mauling.

My notes for the last case history don't mention any injuries other than to the head. I've been in a few head-banging car accidents, and I've seen videos of much more serious collisions. Without a doubt, colliding with the inside of a vehicle can cause a lot of damage to a human skull. But in this case we were looking at injuries that might have been inflicted by a train. To illustrate the extent of injuries, Dr. James Kallman paired a diagram of an uninjured human skull, with 20 or so different bones, with a diagram of his patient's skull. Many of the bones in the upper jaw, nasal area, and forehead were crushed.

These were injuries that the world's best plastic surgeons would have been hard pressed to cope with. Kallman used titanium mesh to recreate the nasal area and eye sockets because the bone fragments were too small to knit together. Kallman described the bones as "pulverized." The "after" photo showed a roadmap of sutures across the patient's forehead and face. In this case, the patient's eyes could not be saved and he was left blind.

Some victims would have lost faith, lost hope, lost their way. But he rebounded, completed several college degrees, and is a leader in his chosen profession.

Separating violence from motive

All of the physicians noted or alluded to the violence of the wounds. The most serious maulings were consistent with injuries that might have been inflicted by a gang of sociopathic thugs over several minutes. One physician wondered how long the bears had worked their victims over. I told them that a bear could inflict this much damage in 10 seconds.

When you watch bears swatting and biting one another on the National Geographic Channel, it's easy to underestimate the force of the blows because bears absorb the shock and seem to be impervious to pain. Human bodies are much more vulnerable to trauma. In one case the patient's most serious wounds were caused by the straps of a bike helmet. Most humans can't injure someone seriously by yanking on a bike helmet. A bear can. Nevertheless, the bike helmet prevented multiple scalp lacerations and perhaps skull punctures. In another patient, the muscular force of a blow drove his rifle against his chest, breaking a couple of ribs.

Understanding motive is critical to understanding why bears attack people. Sometimes you have to step away from the carnage and ask yourself why it happened. All four attacks in the case histories presented at this meeting were defensive attacks. In fact, most bear attacks are defensive. If a bear wants to kill a person, it's not difficult. In all four instances the bear had the opportunity to kill its victim, but chose to retreat.

Calling an attack "defensive" doesn't mean that the bear wasn't serious and isn't capable of inflicting a lot of damage, quickly. But there is a huge difference between a defensive and predatory attack. As skilled as they are in their own profession, doctors understand bears about as well as the next guy. There seemed to be some confusion at the meeting about the bear's motive. One doctor asked, "What part of the victim is consumed first?"

It's important to remember two things. Bear attacks are rare. And predatory bear attacks are much rarer than that. Except in the rarest of exceptions, bears do not consume their victims because they are not trying to kill us for food, they are defending themselves from what they believe is a surprise attack. It's unfortunate for us that they are so adept at self-defense.

But we must separate violence of the attacks from the motive for the attack. Violence used in self-defense is an expression of the will to live.

First, do no harm

In all four cases the physicians applied an ethical directive learned in medical school: first, do no harm. For example, Dr. Troxel decided not to shave her patient's head to avoid getting hair in the wounds.

The physicians at the meeting didn't ask Coltrane to eliminate bears in Anchorage. But occasionally someone else astounds me by asking why we need bears. Why not just eradicate all of them? I imagine these people feel the same antipathy about mosquitoes, not having consulted the birds. People need bears for aesthetic, economic, spiritual, ecological and other reasons.

The world we live on is as complex and sacred as our bodies. Self-preservation requires that we keep all the parts in working order. Though the career paths of physicians and wildlife biologists diverge early, the professions share a profound respect for life. I'd like to think we can share the same ethical precept. First, do no harm.

Rick Sinnott is a former Alaska Department of Fish and Game wildlife biologist. The views expressed here are the writer's own and are not necessarily endorsed by Alaska Dispatch. Contact him at rickjsinnott(at)gmail.com